|
Year |
2002 |
|---|---|
|
Question Number |
103 |
|
Category |
Shoulder and Elbow |
Question
A 45 year-old tennis player sustains an anterior dislocation of the glenohumeral joint after falling on the tennis court. His shoulder is reduced within 1 hour, and radiographs show a concentric reduction with no associated fractures. Examination 2 weeks later reveals that the patient can actively elevate his arm to 60 degrees. His passive forward flexion is 170 degrees. What is the most likely cause for the lack of active shoulder elevation?
1. Glenohumeral ligament injury
2. Axillary nerve palsy
3. Adhesive capsulitis
4. Brachial plexus injury
5. Rotator cuff tear
Figures
Answer (click for answer)
Preferred Answer: 5
Rotator cuff tear occur in 14% to 63% of patients after acute anterior or inferior dislocations. The incidence increases in older persons and has been reported in 63% of patients over 50 years of age. Patients should be reevaluated 7-10 days after the initial injury to look for associated soft tissue injuries. This patient follow up exam is consistent with diagnosis of rotator cuff tear.
Reference: Mark R. Brinker. Review of Orthopaedic Trauma.2001 pp224-225